Individual provider · Type 1 NPI

Willie James Cooper

Substance Abuse Rehabilitation Facility · Richmond, CA

NPI number 1194902262 Active

Practice location

820 23rd St
Richmond, CA 94804-1338

Fax (510) 235-3112

Mailing address

171 S 42nd St
Richmond, CA 94804-3423

Specialties and licenses

TaxonomyCodeLicense
Substance Abuse Rehabilitation Facility Primary 324500000XNone listed

Substance Abuse Rehabilitation Facility: A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.

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About NPI 1194902262

Willie James Cooper's National Provider Identifier is 1194902262, issued on Jan 30, 2008. The primary taxonomy on file is Substance Abuse Rehabilitation Facility (324500000X), and the practice location is in Richmond, CA. The record was last updated on Jan 30, 2008.